Provider Demographics
NPI:1629591524
Name:MCCOY, DARA N (HWS)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:N
Last Name:MCCOY
Suffix:
Gender:F
Credentials:HWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LIME RD NW
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-6867
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 HILLCREST AVE # 521
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-9094
Practice Address - Country:US
Practice Address - Phone:813-575-0782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No175L00000XOther Service ProvidersHomeopath
No175T00000XOther Service ProvidersPeer Specialist
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner